Das zentrale Thema dieser Dissertation ist die Anwendung illustrativer Methoden auf zwei bisher ungelöste Probleme der Strömungsvisualisierung. Das Ziel der Strömungsvisualisierung ist die Bereitstellung von Software, die Experten beim Auswerten ihrer Strömungsdaten und damit beim Erkenntnisgewinn unterstützt. Bei der illustrativen Visualisierung handelt es sich um einen Zweig der Visualisierung, der sich an der künstlerischen Arbeit von Illustratoren orientiert. Letztere sind darauf spezialisiert komplizierte Zusammenhänge verständlich und ansprechend zu vermitteln. Die angewendeten Techniken werden in der illustrativen Visualisierung auf reale Daten übertragen, um die Effektivität der Darstellung zu erhöhen. Das erste Problem, das im Rahmen dieser Dissertation bearbeitet wurde, ist die eingeschränkte Verständlichkeit von komplexen Stromflächen. Selbstverdeckungen oder Aufrollungen behindern die Form- und Strömungswahrnehmung und machen diese Flächen gerade in interessanten Strömungssituationen wenig nützlich. Auf Basis von handgezeichneten Strömungsdarstellungen haben wir ein Flächenrendering entwickelt, das Silhouetten, nicht-photorealistische Beleuchtung und illustrative Stromlinien verwendet. Interaktive Flächenschnitte erlauben die Exploration der Flächen und der Strömungen, die sie repräsentieren. Angewendet auf verschiedene Stromflächen ließ sich zeigen, dass die Methoden die Verständlichkeit erhöhen, v.a. in Bereichen komplexer Strömung mit Aufwicklungen oder Singularitäten. Das zweite Problem ist die Strömungsanalyse des Blutes aus 4D PC-MRI-Daten. An diese relativ neue Datenmodalität werden hohe Erwartungen für die Erforschung und Behandlung kardiovaskulärer Krankheiten geknüpft, da sie erstmals ein dreidimensionales, zeitlich aufgelöstes Abbild der Hämodynamik liefert. Bisher werden 4D PC-MRI-Daten meist mit Werkzeugen der klassischen Strömungsvisualisierung verarbeitet. Diese werden den besonderen Ansprüchen der medizinischen Anwender jedoch nicht gerecht, die in kurzer Zeit eine übersichtliche Darstellung der relevanten Strömungsaspekte erhalten möchten. Wir haben ein Werkzeug zur visuellen Analyse der Blutströmung entwickelt, welches eine einfache Detektion von markanten Strömungsmustern erlaubt, wie z.B. Jets, Wirbel oder Bereiche mit hoher Blutverweildauer. Die Grundidee ist hierbei aus vorberechneten Integrallinien mit Hilfe speziell definierter Linienprädikate die relevanten, d.h. am gefragten Strömungsmuster, beteiligten Linien ausgewählt werden. Um eine intuitive Darstellung der Resultate zu erreichen, haben wir uns von Blutflußillustrationen inspirieren lassen und präsentieren eine abstrakte Linienbündel- und Wirbeldarstellung. Die Linienprädikatmethode sowie die abstrakte Darstellung der Strömungsmuster wurden an 4D PC-MRI-Daten von gesunden und pathologischen Aorten- und Herzdaten erfolgreich getestet. Auch die Evaluierung durch Experten zeigt die Nützlichkeit der Methode und ihr Potential für den Einsatz in der Forschung und der Klinik. / This thesis’ central theme is the use of illustrative methods to solve flow visualization problems. The goal of flow visualization is to provide users with software tools supporting them analyzing and extracting knowledge from their fluid dynamics data. This fluid dynamics data is produced in large amounts by simulations or measurements to answer diverse questions in application fields like engineering or medicine. This thesis deals with two unsolved problems in flow visualization and tackles them with methods of illustrative visualization. The latter is a subbranch of visualization whose methods are inspired by the art work of professional illustrators. They are specialized in the comprehensible and esthetic representation of complex knowledge. With illustrative visualization, their techniques are applied to real data to enhance their representation. The first problem dealt with in this thesis is the limited shape and flow perception of complex stream surfaces. Self-occlusion and wrap-ups hinder their effective use in the most interesting flow situations. On the basis of hand-drawn flow illustrations, a surface rendering method was designed that uses silhouettes, non-photorealistic shading, and illustrative surface stream lines. Additionally, geometrical and flow-based surface cuts allow the user an interactive exploration of the surface and the flow it represents. By applying this illustrative technique to various stream surfaces and collecting expert feedback, we could show that the comprehensibility of the stream surfaces was enhanced – especially in complex areas with surface wrap-ups and singularities. The second problem tackled in this thesis is the analysis of blood flow from 4D PC-MRI data. From this rather young data modality, medical experts expect many advances in the research of cardiovascular diseases because it delivers a three-dimensional and time-resolved image of the hemodynamics. However, 4D PC-MRI data are mainly processed with standard flow visualizaton tools, which do not fulfill the requirements of medical users. They need a quick and easy-to-understand display of the relevant blood flow aspects. We developed a tool for the visual analysis of blood flow that allows a fast detection of distinctive flow patterns, such as high-velocity jets, vortices, or areas with high residence times. The basic idea is to precalculate integral lines and use specifically designed line predicates to select and display only lines involved in the pattern of interest. Traditional blood flow illustrations inspired us to an abstract and comprehensible depiction of the resulting line bundles and vortices. The line predicate method and the illustrative flow pattern representation were successfully tested with 4D PC-MRI data of healthy and pathological aortae and hearts. Also, the feedback of several medical experts confirmed the usefulness of our methods and their capabilities for a future application in the clinical research and routine.

A leishmaniose é causada por tripanossomatídeos do gênero Leishmania que infectam preferencialmente macrófagos. Vários factores influenciam a forma e a severidade da doença: a espécies de Leishmania e a resposta imune do hospedeiro. Considerando a importância da ativação dos macrófagos na infecção, o potencial papel de CD100 na modulação da ativação dos macrófagos e os nossos dados anteriores de que CD100 solúvel (sCD100) aumenta a infectividade pelo parasita, pretendemos caracterizar os efeitos do CD100 na infecção por Leishmania (L.) amazonensis. Descobrimos que ambos, promastigotas e amastigotas, são mais infecciosos na presença de sCD100 e que o receptor CD72 é o responsável pelo aumento da infecção. Experimentos in vitro indicaram índice de infecção similares entre macrófagos nocautes para CD100 e selvagens, mas curiosamente, os animais nocautes infectados desenvolveram lesões significativamente menores do que os selvagens, sugerindo que sCD100 presente em outras células pode influenciar a formação da lesão. / Leishmaniasis is caused by trypanosomes of the genus Leishmania that preferentially infect macrophages. Several factors influence the form and severity of the disease: the species of Leishmania and the host immune response. Considering the importance of the activation of macrophages in infection, potential role of CD100 in the modulation of macrophage activation and our previous data that CD100 soluble (sCD100) increase the infectivity of the parasite, we intend to characterize the effect of CD100 in infection with Leishmania (L.) amazonensis. We found that both promastigotes and amastigotes, are most infectious in the presence of sCD100 and the CD72 receptor is responsible for the increased infection. In vitro experiments indicated similar infection rate of macrophages to CD100 knockouts and wild type, but interestingly, the infected knockout animals developed significantly smaller lesions than wild type suggesting that sCD100 present in other cells may influence lesion formation.

Inom byggbranschen har det konstaterats att BIM och 4D-planering är arbetssätt som effektiviserar och underlättar arbete under projektering- och produktionsskedet. Det har visat sig att dessa tekniker är kostnads- samt tidsbesparande. Åskådliggörande av en visuell modell för planering inför framtida arbetsmoment är av stor vikt för effektivisering. I dagsläget saknar förvaltningsskedet implementering av 4D i arbetsprocessen. För att kunna förvalta en byggnad så måste informationsunderlaget vara korrekt på sådan detaljnivå att drift och underhåll kan utföras effektivt samt att underlaget ständigt kan uppdateras. I dagsläget ställs inte noggranna krav för informationsövergången från tidigare skeden till förvaltning. Förvaltaren har inte heller kompetens att använda sig utav teknik i 4D. Den fjärde dimensionen innefattar tid och en tidplan kopplas till en befintlig 3D-modell. Flertalet studier har genomförts för att ta reda på hur tekniken 4D kan tillämpas inom arbete med förvaltning. Undersökningar kring dagens största problem inom förvaltning har betraktats för belysning av ett lösningsförslag genom tillämpning av tekniken. Stort intresse för implementering av tekniken har skådats. Däremot existerar bristande kunskap för hantering av tekniken. Förvaltare har i studerade fall svårigheter att hantera utdelad information från tidigare byggskeden och bidrar i många fall till en undermålig förvaltning. Detta på grund av att informationen är storartad, svårhanterlig och innehållandes oanvändbara aspekter. Främjande av drift- och underhållsarbetet strävas efter i rapporten genom en enda digitaliserad modell där fjärde dimensionen adderas och där samtlig information till förvaltare sammanställs. Rapportens grund ligger i djupgående intervjuer gällande förvaltningsprocessen och dess problem. En enkätundersökning har använts för ingående kunskap inom ämnet. / Within the construction process it has been shown that BIM and 4D planning are working methods that streamlines and facilitates work during the projection and production phases. It has been shown that these techniques are both cost- and timesaving. Illustrating a visual model to plan for future operations is of great importance for efficiency purposes. In the current situation the management stage is lacking implementation of 4D in its working process. To be able to manage a building, the information base has to be correct in such a detail level so that service and maintenance can be accomplished effectively and that the base constantly is updated. Today the optimal requirements for the information transfer are lacking and the trustee does not have the knowledge to use 4D technique. The fourth dimension includes time and a time schedule is connected to an existing 3D model. Several studies were performed to find out how the 4D technique can be applied for management work. Investigations around today’s problems in management have been observed to illustrate a suggested solution by applying the technique. A great interest for implementing the technique has been seen. On the contrary it exists deficient knowledge for managing the technique. Trustees in studied cases have difficulties to handle the distributed information from previous construction stages and in many cases it causes a poor management. This is caused by the information being too grand, unmanageable and containing unusable aspects. Conducive to service and maintenance are strived for in the report through only one single digitized model where the fourth dimension is added and where all information for trustees is compiled. The foundation of the report is in profound interviews for the management’s work process and its main problems. A survey has been used for thorough knowledge of the subject.

Sweden is perceived to be one of the Building Information Modeling (BIM) leaders in the world. However, studies have shown that 4D BIM, which is a combination of a 3D model and an associated time schedule, is not widely deployed in construction planning practices among contractors. In Sweden many studies focused on BIM adoption in general, but since contractors are the main users of 4D BIM, there is a lack of studies exploring this specific dimension of BIM. This study considers 4D BIM as an innovation; the aim is to find the incentives for and barriers to adopt 4D BIM within the Swedish construction industry. A literature review was conducted and the most common variables were derived; in addition to this, an online questionnaire and a series of interviews targeting Swedish construction companies were conducted. The findings were that 4D BIM is a new start within the Swedish construction industry, where a series of both technical (software, standards, complexity) and non-technical barrier (organizational, lack of client demand, unclear benefits, investment) has an impact on the adoption process. Large companies are the early adopters and use it to maintain their strategic position in the industry, whereas smaller contractors are prone to more barriers and mostly rely on clients´ demand.

Due to the complex anatomy of the heart, heart valves and aorta, blood flow in the aorta is known to be complex and can exhibit a swirling, or helical, flow pattern. The purpose of this thesis is to implement methods to quantify and visualize both the speed of helicity, referred to as the helicity density, and the direction of helicity, which is measured by the localized normalized helicity. Furthermore, the relationship between helicity and geometrical aorta parameters were studied in young and old healthy volunteers. Helicity and geometrical parameters were quantified for 22 healthy volunteers (12 old, 10 young) that were examined using 4D Flow MRI. The relation between helicity and the geometry of the aorta was explored, and the results showed that the tortuosity and the diameter of the aorta are related to the helicity, but the jet angle and flow displacement do not appear to play an important role. This suggests that in healthy volunteers the helical flow is primarily affected by the geometry of the aorta, although further trials should be performed to fully characterize the effects of aortic geometry. The results also show that the helicity changes with age between the two age groups and some of the geometrical parameters also has a significant difference between the age groups.

Just nu pågår stora förändringar i byggbranschen. Kostnaderna för att bygga är idag för stora och branschen letar efter nya metoder för att effektivisera byggandet och minska kostnaderna. Genom att använda sig av den relativt nya Building Information Modeling-tekniken (BIM) öppnar sig flera nya dörrar för vad som är möjligt.BIM är kort sagt en digital modell där all information för hur ett byggprojekts utformning, konstruktion, utrustning och förvaltning ska hanteras. En gemensam modell skapas som arkitekten, byggnadskonstruktörer, vvs-konstruktörer, el-konstruktörer och förvaltare har tillgång till. Ändringar som görs i modellen blir direkt synliga för de andra parterna.Den gemensamma modellen ligger lagrad på en gemensam server för att underlätta kommunikationen.I produktionen har man mycket att vinna av BIM. Först och främst upptäcks många brister och planeringsfel innan de ens kommer ut i produktionen där det blir betydligt dyrare att rätta till. Dessutom följer vid användadet av BIM också en del verktyg som kan användas för planering i produktionen. Två av dessa är kollisionskontroll och 4D-simulering, där tidplanen kopplas samman med ritningen för att simulera fortskridandet av ett byggprojekt.Dessa två verktyg kommer som en biprodukt när BIM nyttjas i ett byggnadsprojekt. I denna rapport presenteras dessa verktyg och vilka fördelar dessa ger i produktionenSyftet med examensarbetet har varit att få en fördjupad kunskap av vad BIM är, både i teorin och praktiskt. Men också att hitta fördelar som Skanska kan nyttja som en följd av användandet av BIM.

Successful management of hydrocarbon reservoirs, geothermal energy extraction sites, radioactive waste and CO2 storage sites depends on a detailed knowledge of fluid transport properties, porosity and permeability. Amongst deformation processes, fluid-rock interaction plays an important role in controlling the petrophysical properties of a rock. The presence of fluids in the rocks induce chemical and physical changes in compositions and texture, affecting porosity and permeability, hence influencing dynamic transport properties and fluid flow. Fluid-rock interaction processes have been deeply investigated in nature and in numerous experimental and numerical modelling studies. However, these studies lack a spatio-temporal characterization of the dynamic evolution of porosity and reaction microfabrics. There is no clear understanding of the spatio-temporal evolution of these properties in three dimensions, and how this evolution affects fluid percolation in the rock. Computed X-ray micro-Tomography (μCT) was applied to investigate these processes in three dimensions and observe their evolution in time (4DμCT). The combination of μCT with 2D analytical techniques (e.g. scanning electron microscope, SEM, electron microcrobe, EMPA, electron backscatter diffraction, EBSD) furthermore enables the extrapolation of the information gained from 2D analyses to the 3rd an 4th dimension (4D μCT). The thesis investigates two different categories of fluid-rock interaction processes, by using 4DμCT to monitor the evolution of mineral reactions (in the first case) and porosity (second case) in relation to strain and time. In the first case study, natural rock samples were analysed. The samples show a compositional change along a strain gradient from olivinic metagabbros to omphacite-garnet bearing eclogites in a ductile shear zone. Synchroton-based x-ray microtomography (sμCT) was applied to document the 3D evolution of garnets along the strain gradient (which represent the 4th dimension). The 3D spatial arrangement of garnet microfabrics can help determine the deformation history and the extent of fluid-rock interaction active during deformation. Results from the sμCT show that in the low strain domain, garnets form a large and well interconnected cluster that develops throughout the entire sample and garnet coronas never completely encapsulate olivine grains. In the most highly deformed eclogites, the oblate shapes of garnets reflect a deformational origin of the microfabrics. EBSD analyses reveal that garnets do not show evidence for crystal plasticity, but rather they highlight evidence for minor fracturing, neo-nucleation and overgrowth, which points to a mechanical disintegration of the garnet coronas during strain localisation. In the second case study, pressure-solution processes were investigated using NaCl as rock-analogue, to monitor the evolution of porosity and pore connectivity in four dimensions, providing a time-resolved characterization of the processes. NaCl samples were uniaxially compacted and μCT scans were taken at regular interval times to characterize the evolution of grain morphologies, pore space and macro-connectivity of the samples. Different uniaxial loads, as well as different bulk sample compositions (phyllosilicates and/or glass beads) were used to investigate their effect on the process. Greater uniaxial loads, and the presence of phyllosilicates within the deforming NaCl columns were found to enhance pressure-solution processes. The pore space becomes highly disconnected in the presence of phyllosilicates, with important implications for fluid percolation and dynamic transport properties. Mean strain rates, calculated from volumetric Digital Image Correlation (3D-DIC) analyses, were found to be higher where phyllosilicates were located. The combination of μCT with volumetric DIC and SEM imaging proved to be an efficient analytical method for investigating the dynamic behaviour of porosity and permeability during ongoing pressure-solution processes. The results showed that fluid-rock interaction critically modifies the rocks at the pore/grain scale, with important consequences on dynamic fluid transport properties. The combination of μCT with classical 2D techniques provided a better understanding on the dynamic evolution of transport properties and fluid percolation during fluid-rock interaction processes, allowing the characterization in three dimensions of reaction microfabrics and porosity.

Inventée en 1983, comme procédé de prototypage rapide, la fabrication additive (FA) est aujourd’hui considérée comme un procédé de fabrication quasiment au même titre que les procédés conventionnels. On trouve par exemple des pièces obtenues par FA dans des structures d’aéronef. Cette évolution de la FA est due principalement à la liberté de forme permise par le procédé. Le développement de diverses techniques sur le principe de fabrication couche par couche et l’amélioration en quantité et en qualité de la palette de matériaux pouvant ainsi être mis en forme, ont été les moteurs de cette évolution. De nombreuses autres techniques et matériaux de FA continuent de voir le jour. Dans le sillage de la FA (communément appelée impression 3D) a émergé un autre mode de fabrication : l’impression 4D (I4D). L’I4D consiste à explorer l’interaction matériaux intelligents (MIs) – FA. Les MIs sont des matériaux dont l’état change en fonction d’un stimulus ; c’est le cas par exemple des matériaux thermochromiques dont la couleur change en réponse à la chaleur ou des hydrogels qui peuvent se contracter en fonction du pH d’un milieu aqueux ou de la lumière. Les objets ainsi obtenus ont – en plus d’une forme initiale (3D) – la capacité de changer d’état (en fonction des stimuli auxquels sont sensibles les MIs dont ils sont faits) d’où la 4e dimension (temps). L’I4D fait – à juste titre – l’objet d’intenses recherches concernant l’aspect fabrication (exploration de nouveaux procédés et matériaux, caractérisation, etc.). Cependant très peu de travaux sont entrepris pour accompagner les concepteurs (qui, a priori, ne sont ni experts FA ni des experts de MIs) à l’utiliser dans leurs concepts. Cette nouvelle interaction procédé-matériau requiert en effet des modèles, des méthodologies et outils de conception adaptés. Cette thèse sur la conception pour l’impression 4D a pour but de combler ce vide méthodologique. Une méthodologie de conception pour la FA a été proposée. Cette méthodologie intègre les libertés (forme, matériaux, etc.) et les contraintes (support, résolution, etc.) spécifiques à la FA et permet aussi bien la conception de pièces que celle d’assemblages. En particulier, la liberté de forme a été prise en compte en permettant la génération d’une géométrie minimaliste basée sur les flux fonctionnels (matière, énergie, signal) de la pièce. Par ailleurs, les contributions de cette thèse ont porté sur la conception avec les matériaux intelligents. Parce que les MIs jouent plus un rôle fonctionnel que structurel, les préoccupations portant sur ces matériaux doivent être menées en amont du processus de conception. En outre, contrairement aux matériaux conventionnels (pour lesquels quelques valeurs de paramètres peuvent suffire comme information au concepteur), les MIs requièrent d’être décrits plus en détails (stimulus, réponse, fonctions, etc.). Pour ces raisons un système d’informations orientées conception sur les MIs a été mis au point. Ce système permet, entre autre, d’informer les concepteurs sur les capacités des MIs et aussi de déterminer des MIs candidats pour un concept. Le système a été matérialisé par une application web. Enfin un cadre de modélisation permettant de modéliser et de simuler rapidement un objet fait de MIs a été proposé. Ce cadre est basé sur la modélisation par voxel (pixel volumique). En plus de la simulation des MIs, le cadre théorique proposé permet également le calcul d’une distribution fonctionnelle de MIs et matériau conventionnel ; distribution qui, compte tenu d’un stimulus, permet de déformer une forme initiale vers une forme finale désirée. Un outil – basé sur Grasshopper, un plug-in du logiciel de CAO Rhinoceros® – matérialisant ce cadre méthodologique a également été développé. / Invented in 1983, as a rapid prototyping process, additive manufacturing (AM) is nowadays considered as a manufacturing process almost in the same way as conventional processes. For example, parts obtained by AM are found in aircraft structures. This AM evolution is mainly due to the shape complexity allowed by the process. The driving forces behind this evolution include: the development of various techniques on the layer-wise manufacturing principle and the improvement both in quantity and quality of the range of materials that can be processed. Many other AM techniques and materials continue to emerge. In the wake of the AM (usually referred to as 3D printing) another mode of manufacturing did emerge: 4D printing (4DP). 4DP consists of exploring the smart materials (SM) – AM interaction. SMs are materials whose state changes according to a stimulus; this is the case, for example, with thermochromic materials whose color changes in response to heat or hydrogels which can shrink as a function of an aqueous medium’s pH or of light. The objects thus obtained have – in addition to an initial form (3D) – the capacity to shift state (according to the stimuli to which the SMs of which they are made are sensitive) hence the 4th dimension (time). 4DP is – rightly – the subject of intense research concerning the manufacturing aspect (exploration of new processes and materials, characterization, etc.). However, very little work is done to support the designers (who, in principle, are neither AM experts nor experts of SMs) to use it in their concepts. This new process-material interaction requires adapted models, methodologies and design tools. This PhD on design for 4D printing aims at filling this methodological gap. A design methodology for AM (DFAM) has been proposed. This methodology integrates the freedoms (shape, materials, etc.) and the constraints (support, resolution, etc.) peculiar to the AM and allows both the design of parts and assemblies. Particularly, freedom of form has been taken into account by allowing the generation of a minimalist geometry based on the functional flows (material, energy, and signal) of the part. In addition, the contributions of this PhD focused on designing with smart materials (DwSM). Because SMs play a functional rather than a structural role, concerns about these materials need to be addressed in advance of the design process (typically in conceptual design phase). In addition, unlike conventional materials (for which a few parameter values may suffice as information to the designer), SMs need to be described in more detail (stimulus, response, functions, etc.). For these reasons a design-oriented information system on SMs has been developed. This system makes it possible, among other things, to inform designers about the capabilities of SMs and also to determine SMs candidates for a concept. The system has been materialized by a web application. Finally, a modeling framework allowing quickly modeling and simulating an object made of SMs has been proposed. This framework is based on voxel modeling (volumetric pixel). In addition to the simulation of SMs behaviors, the proposed theoretical framework also allows the computation of a functional distribution of SMs and conventional material; distribution which, given a stimulus, makes it possible to deform an initial form towards a desired final form. A tool – based on Grasshopper, a plug-in of the CAD software Rhinoceros® – materializing this methodological framework has also been developed.

The aim of this project is to keep the x-ray exposure of the patient as low as reasonably achievable while improving the diagnostic image quality for the radiologist. The means to achieve these goals is to develop and evaluate an ecient adaptive ltering (denoising/image enhancement) method that fully explores true 4D image acquisition modes. The proposed prototype system uses a novel lter set having directional lter responses being monomials. The monomial lter concept is used both for estimation of local structure and for the anisotropic adaptive ltering. Initial tests on clinical 4D CT-heart data with ECG-gated exposure has resulted in a signicant reduction of the noise level and an increased detail compared to 2D and 3D methods. Another promising feature is that the reconstruction induced streak artifacts which generally occur in low dose CT are remarkably reduced in 4D.

Aims : Patients with mild heart failure (HF) who are clinically compensated may have normal left ventricular (LV) stroke volume (SV). Despite this, altered intra-ventricular flow patterns have been recognized in these subjects. We hypothesized that, compared with normal LVs, flow in myopathic LVs would demonstrate a smaller proportion of inflow volume passing directly to ejection and diminished the end-diastolic preservation of the inflow kinetic energy (KE). Methods and results : In 10 patients with dilated cardiomyopathy (DCM) (49 ± 14 years, six females) and 10 healthy subjects (44 ± 17 years, four females), four-dimensional MRI velocity and morphological data were acquired. A previously validated method was used to separate the LV end-diastolic volume (EDV) into four flow components based on the blood's locations at the beginning and end of the cardiac cycle. KE was calculated over the cardiac cycle for each component. The EDV was larger (P = 0.021) and the ejection fraction smaller (P < 0.001) in DCM compared with healthy subjects; the SV was equivalent (DCM: 77 ± 19, healthy: 79 ± 16 mL). The proportion of the total LV inflow that passed directly to ejection was smaller in DCM (P = 0.000), but the end-diastolic KE/mL of the direct flow was not different in the two groups (NS). Conclusion : Despite equivalent LVSVs, HF patients with mild LV remodelling demonstrate altered diastolic flow routes through the LV and impaired preservation of inflow KE at pre-systole compared with healthy subjects. These unique flow-specific changes in the flow route and energetics are detectable despite clinical compensation, and may prove useful as subclinical markers of LV dysfunction.